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Population ageing impact is exaggerated

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Researchers from the University of Edinburgh, writing an analysis published today in the BMJ, say the extent, speed, and effect of population ageing have all been exaggerated. The standard indicator of population ageing – the old age dependency ratio – does not take proper account of falling mortality, and that the numbers of dependent older people in the UK and other countries have actually been falling in recent years.

This view is argued by Jeroen Spijker, senior research fellow and Professor John MacInnes, both of the School of Social and Political Science, University of Edinburgh. Population ageing has become a growing concern in developed countries in recent years and there are now more people over the age of 65 in the UK than there are children aged 15 years old.

Policy makers have often raised concerns about this trend because for every worker paying tax and national insurance, there are more older people who make greater demands on social insurance, health, and welfare systems and have increasing morbidity and disability.

The old age dependency ratio (OADR) takes the number of people who have reached the state pension age and divides it by the number of working age (16-64 years) adults to estimate the proportion of older people relative to those who pay for them. However, the authors argue that this overlooks the fact that rising life expectancy makes these older people “younger,” healthier, and fitter than their peers in earlier groups.

In the year 1900, the average life expectancy for a 65-year-old woman in England and Wales was 11 years and 10 years for men, but today, such a woman could live another 21 years and a man, another 18 years. The authors said this was crucial because many behaviours and attitudes (including those related to health) are more strongly linked to remaining life expectancy than to age.

The OADR also assumes that everyone of working age actually works, but data show that in Britain, there are more dependents of working age (9.5 million) than there are older people who do not work.

The authors calculated an alternative measure – the real elderly dependency ratio – which was based on the sum of men and women with a remaining life expectancy of up to 15 years divided by the number of people in employment, regardless of age.

Using this measure, they found that old age dependency in the UK has fallen by one third over the past four decades – and is likely to stabilise close to its current level. They concluded: “The different story of population ageing told by our real elderly dependency ratio has several important implications for health policy and clinical practice.

“Our calculations show that over the past four decades the population, far from ageing, has in fact been getting younger, with increasing numbers of people in work for every older person or child.”

They accepted that demand for services would rise, but that it would continue to be driven by other factors such as progress in medical knowledge and technology and growing complexity of co-morbid age related conditions.

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